- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $260.57 / $2,670.00 / $5,454.00
| Facility | | $260.57 | $2,670.00 | $5,454.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $163.63 / $260.57 / $523.28
| Professional | | $163.63 | $260.57 | $523.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $544.95 / $3,764.00 / $12,379.00
| Facility | | $544.95 | $3,764.00 | $12,379.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $243.92 / $554.77 / $2,262.80
| Professional | | $243.92 | $554.77 | $2,262.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $262.00 / $340.60 / $601.03
| Facility | | $262.00 | $340.60 | $601.03 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $358.42 / $521.08 / $760.30
| Professional | | $358.42 | $521.08 | $760.30 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $361.88 / $622.78 / $1,156.58
| Professional | | $361.88 | $622.78 | $1,156.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $226.01 / $477.74 / $6,679.00
| Facility | | $226.01 | $477.74 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $364.53 / $460.62 / $823.56
| Professional | | $364.53 | $460.62 | $823.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $285.07 / $611.25 / $904.28
| Professional | | $285.07 | $611.25 | $904.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,885.42 / $2,538.81 / $4,320.31
| Facility | | $1,885.42 | $2,538.81 | $4,320.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $229.77 / $353.08 / $684.57
| Professional | | $229.77 | $353.08 | $684.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.27 / $4,249.00 / $16,394.00
| Facility | | $1,108.27 | $4,249.00 | $16,394.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $389.63 / $848.79 / $2,262.80
| Professional | | $389.63 | $848.79 | $2,262.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $336.15 / $544.16 / $1,091.24
| Professional | | $336.15 | $544.16 | $1,091.24 |